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Gastroenterology  (Expert Forum)
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ABDOMINAL PAIN AND SERVERE BLOATING
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D. Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

ABDOMINAL PAIN AND SERVERE BLOATING

by kgandas, Jun 07, 2003 12:00AM
I AM A 43 YR OLD FEMALE THAT HAS BEEN EXPERIENCING SEVERE ABDOMINAL BLOATING AND PAIN WITH IT. I WENT TO MY REG. DR AND WAS REFERRED TO A GYN. WHO RULED OUT ANY PROBS IN THIS AREA. I WENT TO A GASTRO DR AND WAS DIAGNOSED WITH IBS. DR PRESCRIBED PAMINE (NO HELP. THEN CAME HYOSCYAMINE THE METOCLOPRAMIDE ALL NO HELP.I HAVE HAD A BARIUM ENEMA, CT SCAN, BLOOD WORK AND STOOL TEST. ALL SHOW NORMAL. I HAVE HAD DIAREHA CONSTANTLY FOR MORE THAN 15 YEARS (AFTER GALLBLADDER REMOVAL).DR KEEPS AKING IF THIS IS SOMETHING THAT I CAN LIVE WITH. NO!!! THEY ARE RUNNUNG OUT OF IDEAS. BLOATING SEEMS TO BE ASSOCIATED WITH PHYSICAL ACTIVITY. IE. VACUUMING, LIFTING, TWISTING. IT IMMEDIATELY CAUSES SHARP ABDOMINAL PAINS MUCH LIKE LOTS OF PINCHES AND I BLOAT TO THE POINT OF LOOKING PREGNANT.THE "PINCH" FEELS LIKE IT IS RIGHT BEHIND THE GALLBLADDER SCAR. DR. AVOIDS LOOKING IN THIS AREA, SAYING NOTHING FROM THE GALLBLADER SCAR OR THIS AREA COULD CAUSE THESE SYMPTOMS. I CAN PRESS THIS AREA WITH MY HAND AND FEEL THE PAIN AND BLOAT IMMEDIATELY (5 MINUTES). THIS BLOATING VARIES IN HOW LONG IT LASTS. LAYING DOWN AND RELAXING WILL USUALLY GET IT TO GO DOWN IN 3 OR 4 HOURS.SOMETIMES LAST FOR DAYS. ONE OF THE DR. DID A ULTRASOUND AND NOTED BOWEL DISTENSION. A BOWEL MOVEMENT DURING THE BLOATING DOES NOT RELIEVE THE PRESSURE. IT DOES NOT SEEM TO BE ASSOCIATED WITH ANY SPECIFIC FOODS AND I WILL BLOAT UP WHETHER I HAVE EATEN OR NOT. I AM GETTING FRUSTRATED WITH THIS CONDITION AS IT IS HARD TO FUNCTION WHEN TURNING SIDEWAYS OR LIFTING A 10LB BOX RUINS YOUR ENTIRE DAY. MY REGULAR DR AND THE GYN. WERE BOTH SHOCKED WHEN THEY PRESSED THIS AREA OF MY ABDOMIN AND WATCHED THE BLOATING OCCUR. I AM ON ATENOLOL FOR HIGH BLOOD PRESSURE AND LIPITOR. I DON'T HAVE MUCH FAITH IN OUR LOCAL HEALTH CARE, BUT I AM NOW HEAVILY INVESTED IN TESTS AND DR BILLS WITH NO INSURANCE AND WOULD LIKE ANY IDEAS YOU MIGHT HAVE. THANKS
Doctor's Answer

by Kevin Pho, MD, Jun 07, 2003 12:00AM
Hello - thanks for asking your question.



You note bloating and chronic diarrhea.  Tests include barium enema, stool tests, CT scan, and "blood work".  



There are many causes for bloating - it seems that your physicians have treated you for irritable bowel disease with the medications you have mentioned.  



Other causes include various malabsorption syndromes (such as lactose deficiency, carbohydrate malabsorption, or fat malabsorption), inflammatory bowel disease, celiac disease, or adhesions as surgeon has mentioned below.  



If endoscopy has not been performed (I see no mention of this), I would suggest a colonoscopy to evaluate for inflammatory bowel disease or any other anatomical abnormalities that can be causing your symptoms.  



Further tests such as fecal fat tests, tests for carbohydrate malabsorption or lactose deficiency, and antibody tests for celiac disease should all be considered.  



If those tests are negative, then you may want to consider surgical options (i.e. laparoscopy) to evaluate your symptoms.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Thanks,

Kevin, M.D.

Member Comments (12)

by surgeon, Jun 07, 2003 12:00AM
Possibilities include an incisional hernia or adhesions causing intermittant obstruction. Unless the xrays were done at the time you were bloated, they may not show anything. Ultrasound over the incision might show a hernia. Better yet, see a surgeon with idea of whether you could be having intermittant obstruction. Laparoscopy to look for and treat adhesions is a fairly minor procedure (not without risk, like any procedure). In some cases, if bloating is documented, exploration is appropriate even when the prior tests are ok.

by LGworried, Jun 07, 2003 12:00AM
To: Surgeon
Dear Surgeon,

You have been so helpful in the past.  I was wondering if you could help me again.  I just need an opinion. I have a weird feeling above my left knee when leaning on it.  It is not painful, red, swollen(I don't think, looks normal), heavy, or numb.  It just feels when I lean on it, something is there.(like extra tissue or meat) I have had no injury to it.  I am worried it is a clot? What do you think? No history of clots, even while pregnant. No recent surgery. Am I being paranoid? How can Ihome treat/ Should I see doc right away?

Thanks,

LGWorried

by LGworried, Jun 07, 2003 12:00AM
To: Surgeon
FYI:

History of other sensory sensations, went to a neurologist, completely normal neurological exam.

by mountaInbeauty, Jun 07, 2003 12:00AM
wondering if you ever actually found out what was wrong.

My mother is having the same symptoms as well as lots of

gas.  All tests continue to show nothing yet she is in major

pain.  she had surgery awhile back and a hernia came from that

in which a mesh was put in....stomach area....ever since then

she has been in pain with severe bloating and gas also trouble

doing a bowel movement.  any ideas or suggestions appreciated????

by yoshi, Jun 07, 2003 12:00AM
hello,ever heard of fungal or yeast infection??

in and out of hospital,having something removed,taking anti biotics,eating too much yeast food-beer,mushroom,white bleached flour,moldy preserved food,live in an old house etc etc.

yeast and fungus can cause bloat big time,plus mucous in stool and constipation and excessive sleep or cant sleep.

craving for starchy junk food and the list goes on.

get some good yogurt from health food store ,not the trashy food laden supermarket type and see if it makes some difference.

by jpmehta, Jun 08, 2003 12:00AM
Cronic Giardiasis also shows the similar symptoms. Check for that.

by rhyanen, Jun 10, 2003 12:00AM
Did your GI test you for Celiac Disease?  It can cause chronic diarrhea and an extended, bloated abdomen as well.  2.2 million Americans have Celiac disease, but only 97% are actually diagnosed.  If you haven't been tested for this disorder, I would again consult your physician so he/she may run a Celiac Panel.



Good luck!



rhyanen

by rhyanen, Jun 10, 2003 12:00AM
OOPS.  I meant that only 3% are actually diagnosed with Celiac, and the 97% are actually undiagnosed.  Having a brain fog moment here.